MEDICARE: TIMOTHY R HEATH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	H9984	TX
2	207R00000X	Internal Medicine Physician	H9984	TX
3	208M00000X	Hospitalist Physician	H9984	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00828165	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8BQ004	OTHER	TX	BCBS
4	8CR923	OTHER	TX	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	035070440	OTHER	TX	TMHP-CSHCN

General Provider Information

NPI Number	:	1053315598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY R HEATH MD

Provider Business Mailing Address
First Line	:	1133 JOHN FREEMAN BLVD STE JJLS80
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2809
Country	:	US
Telephone Number	:	713-500-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	5656 KELLEY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77026-1967
Country	:	US
Telephone Number	:	713-566-5100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	10/19/2023

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Directions to “ TIMOTHY R HEATH MD” Practice Location

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